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Abstract

Methods: As part of the AHA Mission LifeLine program, six Emergency Medical Systems (EMS) in South Florida organized a conference with CEOs of 14 hospitals providing primary PCI for STEMI. Participation in STEMI network required direct commitment to provide timely PCI, defined as a door to balloon (D2B) time of <60 minutes and an ED delay time of <15 minutes. If such metrics were not reached, ED would be bypassed by the EMS. They were requested to sign a performance contract and to submit detailed quarterly data.

Results: From 04/2007 until 12/2015, a total of 5,507 patients had STEMI and received primary PCI in South Florida. Of those 1,372 (27%) were females with a median age of 62 [53, 73] years. Time metrics decreased steadily over time [(1) Median EMS to ED time (2007: 37 vs. 2015: 31 mins, p <0.001); (2) Median ED elapsed time (2007: 30 vs. 2015: 16 mins, p <0.001); (3) Median ED to femoral access time (2007: 50 vs. 2015: 34 mins, p <0.001); (4) Median door to balloon time (2007: 61 vs. 46 mins, p <0.001)]. Of total population, 3,932 (71%) were Hispanics, 931 (17%) were Caucasians, 469 (9%) were African Americans, 151 (3%) were classified as other, and 24 (0%) were Asian/Pacific. Door to balloon time was similar across different ethnic groups, which steadily decreased over study period (Figure).

Conclusion: Door to balloon time in network is lower than what has been previously reported. AHA Mission Lifeline STEMI network through EMS can result in improvement in ethnic disparities of STEMI care.